PROMISSORY NOTE: General form to document a promise to repay a debt

$ _________

_________ [date of making]

___________________ [place of making]

For value received, I, _________, of _________[address], _________[city], _________ County, _________[state], promise to pay _________[to the order of _________ or to _________ or order] at _________[address], _________[city], _________[state], _________[designate time payable, such as: _________ months after date without grace or on _________(date), or if payable on demand, on demand] the sum of $_____, _________[with interest at the rate of _________% annually].

[Signature of maker]

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2005-02-17

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